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                MESSAGE FROM THE EXECUTIVE

            

            
                The first Southern African HIV
                Clinicians Society meeting that I attended was in or around 2002, at
                the Pharmaceutical Society in Glenhove Road. Professor Gary Maartens
                spoke on isoniazid preventive therapy, and the room was full (it was
                the last meeting in that too-small venue). The initial function of the
                Society was to help a group of private doctors to better manage HIV
                infections.

                
                

                In the dark years, it seemed
                unlikely that ART would ever be affordable and available in either the
                public or private sectors. I was working in a public service clinic,
                and all we could do was treatment and prevention of opportunistic
                infections. ART was for a select few with money or taking part in
                research trials. Then, on 1 April 2004, the first patients accessed
                therapy from the government programme. For months after that, I went
                and opened the pharmacy cupboards – just to look at the
                medicines. The atmosphere at the clinic changed; while people arrived
                very ill, many got better. Informal support groups formed. I remember
                celebrating the first 1 000 patients on treatment at our clinic. Today,
                over 15 000 people receive treatment there.

                
                

                South Africa now has the largest
                ART programme in the world, with some 1.5 million on treatment. The
                DoH, under the leadership of Dr Aaron Motsoaledi, commenced the
                largest-ever HIV testing campaign last year, and over 15 million South
                African were tested for HIV. There has been a reduction in
                mother-to-child transmission to 3.5%.

                
                

                So do we have it all sorted out,
                and is there no need for a Southern African HIV Clinicians Society?
                What are the present challenges? What role will I play as President? I
                have always seen the function of the Society as pushing the boundaries
                and leading the way in getting the best possible care to HIV-infected
                South Africans. We must ensure that our guidelines for all aspects of
                HIV care and prevention are challenged and aligned with international
                guidelines. Research in South Africa is of the highest standard. Our
                researchers have been involved in many of the latest breakthroughs in
                HIV, including early treatment for infants (CHER), the use of treatment
                as prevention (HPTN052) and microbiocides (CAPRISA 004). As soon as any
                research breakthroughs are made, we in the Society need to assist the
                DoH to implement them. And TB must receive more attention. South
                Africa's TB incidence is high – second only to Swaziland’s
                – and we rank fourth-highest in the world in multidrug-resistant
                TB incidence. This huge increase in TB has been driven largely by HIV
                infection. It seems a great pity to have made such massive progress in
                HIV treatment, and then lose our people to TB.

                
                

                
                

                
                

                
                

                FRANCESCA CONRADIE

                
                

                President

                
                

                Southern African HIV Clinicians Society

                
                

                Johannesburg